Laserfiche WebLink
.r <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF OUR RIGHT TO RECOVER FROM <br />OTHERS ENDORSEMENT - CALIFORNIA <br />Policy Number: 72WEGAM3JXV <br />Endorsement Number: <br />Named Insured and Address: VCA Consultants, Inc. <br />1845 W Orangewood Ave., Suite 200 <br />Orange, CA 92868 <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our <br />right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br />perform work under a written contract that requires you to obtain this agreement from us.) <br />You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work <br />described in the Schedule. <br />The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due <br />on such remuneration. <br />SCHEDULE <br />Person or Organization <br />Job Description <br />Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights <br />from us <br />Form WC 04 03 06 (1) Printed in U.S.A. <br />rw � Z�Dx . <br />/OSC /omoq <br />RhkhYnalm l0lm IAde <br />